Wednesday 22nd of October 2014 02:58:35 AM

You buy the Truth, we pay the Price
Monday, 06 October 2014 07:08 By Yoweri Kaguta Museveni
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Should we involve Uganda in endless wars with our trade partners on account of this?

“Abaine enaama, baita abatagiine” - meaning the ones who caucus first, can overpower the ones who do not caucus. Ekitetekatekirwe, embwa ekahuunga omukaro - sudden confrontation can lead to surprising outcomes like a dog running away from dried and spitted meat, thinking that it is a stone somebody has thrown at it. Obuyaayo bwaraba aha - a rubble has passed by here which is a riddle (ekiito)that is translated as “soldiers’ without a commander”.

Endimi nyingyi itukuriza obushera - many tongues spoil the broth.

All these proverbs refer to the problem of the dangers of lack of co-ordination and planning. Then there is another different angle that emphasises prioritisation. The relevant proverb says: “owabinga ibiri, imutsiga” - the one who tries to chase two animals when hunting, ends up failing to kill any.

By 1965, Uganda was moving fast towards a failed state on account of the pseudo - ideologies of sectarianism, chauvinism and disorientation. That is when the precursor of the NRM emerged in the form of some chapters of the student movement. The new things these students movement brought were, mainly, two: first of all, patriotism in ideology (anti-sectarianism and anti-chauvinism); secondly, organisational cohesion, discipline and very strict prioritisation. That is how the NRM steadily grew and, eventually, gained the upper hand and dominated the political space.

Monday, 29 September 2014 06:21 By Morris DC Komakech
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Militarise agriculture, education, rural economies, and breaking the spirit of the country

The Pope has decried the rampant conflicts in and around the world, calling it "piecemeal World war III". War is not a game; it destroys lives and livelihoods, ravages homes, and stalls the very essence of humanity. Ugandans have experienced so many senseless wars with the same outcomes that they have become resistant to war-talk as an alternative of changing government. This is one aspect where rational and politically conscious individuals should applaud our opposition leaders who reject war talk.

The Pope can as well be right in his assessment that the world is experiencing piecemeal world War III.  According to the Center for Systemic Peace, since 1946, there have been 331 episodes of armed conflicts around the world. Currently, there are 32 armed conflicts going on around the world. The US has launched 201 of the 331 wars and masterminded many others, according to reports in a 2012 Journal of Peace Research [49(4): 565-575].

Statistic shows that since the end of WWII in 1945, over 50 million people have been killed, tens made homeless and million others left with injuries and bereavement. In the history of warfare, the twentieth century has been accredited as the bloodiest. According to sources, three times more people have lost lives in wars in the last ninety (90) years than the previous five hundred years.

Monday, 22 September 2014 06:31 By Dani Rodrik
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How do politicians who are unresponsive to the interests of the vast majority of their constituents get elected?

It is hardly news that the rich have more political power than the poor, even in democratic countries where everyone gets a single vote in elections. But two political scientists, Martin Gilens of Princeton University and Benjamin Page of Northwestern University, have recently produced some stark findings for the United States that have dramatic implications for the functioning of democracy – in the US and elsewhere.

The authors’ research builds on prior work by Gilens, who painstakingly collected public-opinion polls on nearly 2,000 policy questions from 1981 to 2002. The pair then examined whether America’s federal government adopted the policy in question within four years of the survey, and tracked how closely the outcome matched the preferences of voters at different points of the income distribution.

When viewed in isolation, the preferences of the “average” voter – that is, a voter in the middle of the income distribution – seem to have a strongly positive influence on the government’s ultimate response. A policy that the average voter would like is significantly more likely to be enacted.

Monday, 15 September 2014 07:01 By Joseph Were
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Big money deals expose political power fights

The scandal over the award of the contract to upgrade the 74km Mukono-Katosi road to an alleged fake company, Eutaw Construction Company Inc., has exposed how corruption can be the handwork of top-level politics. It gives a glimpse of the behind-the-scenes political fights happening today that sometimes leave even President Yoweri Museveni helpless.

When Museveni commissioned the Mukono-Katosi road on July 7, 2014, for instance, he was fully aware of the scandal swirling around it but he was helpless to stop it.  He had several reports on his desk that Eutaw might in fact be a fake company.  The office of the IGG had first complained about it in February 2014.

But Museveni appears to have been aware that recurrent public procurement debacles in State House are a result of intra-NRM political manoeuvres and systemic constraints, and not merely corruption. He knows that even if a public official desired to do good under the current system, they might fail and that politico-structural remedies are required, not purges of individuals or single projects.

Monday, 08 September 2014 06:45 By Prabhjot Singh
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Ensuring that people seek care for other ailments amidst fear of clinicians is a challenge

In Sub-Saharan Africa, any child with a fever should receive immediate medical care to prevent death from malaria or pneumonia. But, as panic about the spread of Ebola grips Liberia – as well as Sierra Leone, Guinea, Nigeria, and Senegal – people there are increasingly associating clinicians and health-care facilities with exposure to the disease. Ensuring that they continue to seek care when they need it requires improvements to frontline clinics and investment in locally hired community health workers (CHWs) to reach the vulnerable in their homes.

To be sure, the shortcomings of Liberia’s health-care system long preceded the Ebola outbreak, with roughly 28% of the country’s four million citizens lacking access to adequate facilities. The 2003 Accra Comprehensive Peace Agreement may have ended years of civil war, but it left the country with only 51 doctors and decimated infrastructure.

With very few qualified health-care professionals, repairing the health-care system demands more than building new hospitals and clinics across Liberia’s densely rain-forested countryside. Fortunately, the government, like others in Sub-Saharan Africa, recognises the need to invest in training CHWs in rural counties to treat diarrhea, pneumonia, and malaria – the three major causes of death in children under five years old.

By definition, CHWs have deep relationships with their communities; including traditional healers, which enables them to help the formal health-care system calibrate its approach. At the same time, mobile technologies facilitate quality control and supervision, while providing CHWs with expert clinical support.

In March, Liberia’s health ministry, in collaboration with United Nations agencies, USAID, local and international NGOs, and private companies, created a comprehensive scale-up plan for the country’s community-health program. But Ebola struck soon after, shifting attention to clinics, quarantines, and reports of cures.

The World Health Organization (WHO) has played a central role in coordinating the international response along with national governments, aid groups like Doctors Without Borders, and the US Centers for Disease Control and Prevention (CDC). With the epidemic still growing, the public-health community is attempting to mount an effective response, using a $100 million funding boost to deploy clinicians, epidemiologists, and other experts.

To put this in context, the Liberian plan unveiled in March estimated that a national CHW network would cost some $20 million annually. To be sure, investments in CHWs should not come at the expense of critical public-health measures to slow the spread of Ebola or support for frontline clinics. But without continued investment in CHWs, whose costs are modest compared to those of traditional health-care systems, it will be difficult for the international community and national governments to stop the spread – and prevent the recurrence – of Ebola and other devastating epidemics.

There are two basic approaches to building a health-care system. One has hospitals at the center and clinics radiating outward; the other is founded on social networks and mobilised by CHWs. If the first is too rigid, diseases and their social context evolve beyond its means. If the second is too flexible, the ability to carry out technically complex work is compromised.

Striking the right balance is particularly challenging in areas where access is limited or trust is lacking. Doing so in the midst of an epidemic is even more complicated, owing to the social dimension of epidemics. In other words, how people respond when a child or family member falls ill is shaped by their friends’ and neighbors’ experiences, the availability of health-care services, and the community’s perception of those services; this response, in turn, determines how and to what degree the disease will spread.

As a CDC expert explained, CHWs are the key to stopping Ebola, because anybody who shows symptoms of the disease becomes a “suspected patient,” all of whose contacts must be followed for another three weeks. “Every day, except Sunday, the workers report their findings to a supervisor.”

One organisation, Last Mile Health, has built a network of 300 CHWs that serves 30,000 patients, providing access to basic clinics even in places like hard-to-reach Konobo, Liberia. The organisation’s hybrid structure is capable of addressing regular challenges, while retaining the flexibility to respond to extraordinary developments.

As the rainy season approaches, threatening to facilitate the emergence of multiple epidemics that will overwhelm the health-care system’s capabilities, the need to mobilise, train, and equip citizens to respond has become even more urgent. This demands a combination of targeted development aid, domestic investment, expert support, and on-the-ground perspectives from Sub-Saharan countries that have successfully scaled up CHW networks.

The same is true for all of the countries with active Ebola cases. Indeed, buttressed by the organisations behind the One Million CHWs campaign, these countries are already working to scale up CHWs. But they need more support, and international agencies and development banks remain too focused on containing the Ebola epidemic to offer the needed backing.

International organisations must recognise that they do not have to choose between supporting traditional health-care investments and emergency-response efforts. Long-term investment in credible health-care systems is the only way to head off future epidemics. Otherwise, Sub-Saharan Africa’s people will forever struggle to overcome avoidable health crises.

Prabhjot Singh, a professor of international and public affairs at Columbia University, is Director of Systems Design at the Earth Institute and Chair of the One Million Community Health Worker Campaign in Sub-Saharan Africa.




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